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Goal: To provide an overview of buttonhole cannulation and rope-ladder cannulation techniques, and which technique presents an increased risk of infection in adult patients on hemodialysis.

Objectives:

Explain the rationale for improving cannulation procedures as evidenced in the literature review presented.
Outline the measures taken by the authors to reduce access site infection when using the buttonhole cannulation technique.
Discuss the use of the Buttonhole Assessment Tool in the attempt to reduce the risk of access site infection in patients receiving hemodialysis via the buttonhole cannulation technique.
Describe the revised buttonhole cannulation technique implemented by the authors in their facility.

Statement of Disclosure: The authors reported no actual or potential conflict of interest in relation to this continuing nursing education article.

Erin Birchenough

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